Objective:This study aims to select the more suitable testing method for early screening of uterine cervical cancer to protect susceptible populations. Application value was compared between the two methods of high-risk HPV detection in early screening of uterine cervical cancer. Methods:The two methods, namely, fluorescence quantitation polymerase chain reaction(PCR) and HC2-HPV-DNA, were used to detect the infection status of 13 high-risk HPV types during women's health examination. The examined women were divided into four groups according to age (23 to 29 years old, 30 to 39 years old, 40 to 49 years old, and 50 to 58 years old). Statistical methods were applied to analyze the results. Results:The detected positive rates by fluorescence quantitation PCR and HC2-HPV-DNA were 15.93%(140/879) and 11.83%(104/879), respectively, among the 879 examined women. The common positive and negative rates were 9.56%(84/879) and 81.80%(719/879), respectively. The results of the two methods showed that the infection positive rate was obviously higher in the 40 to 49 year old and 50 to 58 year old groups. Statistical difference was observed between fluorescence quantitation PCR and HC2-HPV-DNA in detecting high-risk HPV types (P<0.05). Conclusion:HC2-HPV-DNA is superior to fluorescence quantitation PCR for detecting 13 high-risk HPV types and is more suitable for large-scale health screening. HC2-HPV-DNA can be applied in large-scale early screening of uterine cervical cancer, especially in women>40 years old who are at high risk of HPV, to prevent uterine cervical cancer efficiently.

Objective To investigate the relationship between osteoprotegerin ( OPG ) gene polymorphisms and ischemic stroke etiological subtypes, as well as the extent and distribution of cerebral atherosclerosis ( AS) lesions.Methods Patients with ischemic stroke included 285 cases of large-artery atherosclerosis (LAA), 91 cases of small-artery occlusion (SAO) and 42 cases of purely AS, and 165 healthy controls were enrolled in this study.The LAA group was respectively divided into 3 subgroups according to the number and the distribution of stenostic vessels.Genotyping of three single nucleotide polymorphisms (SNPs;rs2073617, rs3134069, and rs3102735) in the promoter region of the OPG gene was performed by polymerase chain reaction-restriction fragment length polymorphism.Results Regarding the three SNPs of OPG gene, the frequence of genotype CC/CT and the prevalence of allele C of rs3102735 were higher in the LAA group contrasting with the control group ( 24.04% vs 14.85%, 44.21% vs 27.88%,χ2 =10.758, 11.804, P =0.001,0.024).However, comparisons of other frequences of genotypes or alleles did not reveal any significant differences among the LAA group, the SAO group, the AS group and the control group, as well as among different subgroups of LAA group.Haplotype analysis revealed that the frequencies of haplotype C-C-T in LAA group and SAO group were significantly lower ( 0.023, 0.017 vs 0.068,χ2 =10.399, 5.841,P=0.001, 0.016), while that of haplotype T-A-C was significantly higher in SAO group(0.043 vs 0.016,χ2 =4.708, P=0.030) compared with controls.Conclusions Our findings indicate that OPG gene polymorphisms might be associated with increased susceptibility to LAA ischemic stroke.But we fail to show association of OPG gene with the extent and distribution of AS.

Objective To investigate the distribution of Helicobacter pylori (Hp) infections among general population in Tianjin. Methods Individuals (n=11 096) who visited our hospital for medical examination and H. Pylori infection screen were included in the research objects. Rapid urease method was utilized to rapidly detect H. pylori infection among the popultion. Individuals were grouped based on their gender, age and occupations, and then were analyzed. Results H. pylori-positive rate was 30.52%(3 386/11 096) in 11 096 individuals, in which there were 34.77%(1 784/5 131) male and 26.86%(1 602/5 965) female respectively. Individuals were divided into 5 groups according to their ages:19 to 29 years old group, 30 to 39 years old group, 40 to 49 years old group, 50 to 59 years old group, 60 to 69 years old group and 70 to 92 years old group. The positive rates of H. pylori increased with age:19.50%( 379/1 944 ) in 19-29 years old group, 25.82%(650/2 517 ) in 30-39 years old group, 31.59%( 908/2 874 ) in 40-49 years old group, 37.48%(915/2 441 ) in 50-59 years old group, 41.09%( 353/859 ) in 60-69 years old group and 39.18%(181/462) in 70-92 years old group. The differences in positive rates between different age groups were all of statistically significant (P<0.05). Individuals were also divided into seven groups according to their occupations: medical worker group, worker group, teacher group, engineer group, clerk group, civil worker group and other career group. The positive rates of H. pylori infection were 25.42%(586/2 305), 29.35%(1 062/3 618), 30.61%(360/1 176), 32.49%(116/357), 33.44%(205/613), 34.52%(455/1 318)and 35.23%(602/1 709) respectively. The positive rate was 25.42% (586/2 305) medical workers, which was lower than that of other occupation groups with significant difference (P<0.002). Conclusion Good management of H. pylori diagnosis and treatment in mid-dle age and elderly together with popularizing knowledge of H.pylori prevention can effectively reduce H.pylori incidence.

Objective To investigate the relationship between the plasma galectin-3 level and the severity of cerebral artery atherosclerosis as well as the prognosis of patients with large artery atherosclerosis (LAA) stroke.Methods According to the TOAST classification,105 patients with LAA stroke,50 patients with small artery occlusion (SAO) stroke,33 patients with asymptomatic cerebral artery stenosis,and 60 healthy controls were enrolled.The plasma galectin-3 level was measured using enzyme-linked immunosorbent assay.According to the number of cerebral arteries with atherosclerosis,the LAA group was divided into single-branch lesions group (n =30),double-branch lesions group (n =30) and multi-branch lesions group (n =45).Plasma galectin-3 levels were compared among the three subgroups,and the associations between galectin-3 and the severity of cerebral atherosclerosis were analyzed.The LAA group patients were followed up for three months,and the value of galectin-3 on predicting the prognosis of patients with LAA stroke was assessed using the receiver operating characteristic (ROC) curve and the modified Rankin scale (mRS) scores.Results The plasma galectin-3 level in LAA group ((13.64 ± 3.08) ng/ml) was significantly higher than in SAO group ((12.20 ± 2.88) ng/ml) and control group ((11.89 ± 2.93) ng/ml;t =2.790,3.617,P =0.006,0.000).Besides,the plasma galectin-3 level in asymptomatic stenosis group ((13.94 ± 2.89) ng/ml) was significantly higher than in SAO group and control group (t =2.695,3.238,P =0.009,0.002).However,the differences between asymptomatic stenosis group and LAA group,SAO group and control group were not statistically significant.In LAA group,the plasma galectin-3 level in multi-branch lesions group ((15.02 ±2.94) ng/ml) was significantly higher than in double-branch lesions group ((13.47 ± 2.88) ng,/ml) and single-branch lesions group ((11.73 ± 2.43) ng/ml;t =2.261,5.080,P =0.027,0.000).The plasma galectin-3 level in double-branch lesions group was significantly higher than in single-branch lesions group (t =2.532,P =0.014).The plasma galectin-3 level and the range of atherosclerosis and mRS scores were positively correlated (r =0.433,0.629;P =0.000,0.000).The area under the ROC curve of plasma galectin-3 level and prognosis was 0.812 (95％ CI O.726-0.897,P =0.000).Conclusions The plasma galectin-3 level was found associated with the severity of cerebral artery atherosclerosis,but not with acute onset of LAA and SAO stroke.Galectin-3 may be involved in the inflammatory pathogenesis and development of cerebral atherosclerosis,and may have the potential to become a plasma marker for evaluating the severity of cerebral artery atherosclerosis and judging the prognosis of patients with LAA stroke.

Tumor suppressor genes breast cancer gene 1/2 ( BRCA1/2) play key roles in DNA damage repair pathways and are essential for maintaining genome integrity. The earliest studies found that BRCA1/2 are the main pathogenic factors of hereditary breast/ovari-an cancer syndrome, and the risk of breast cancer and ovarian cancer is greatly increased in BRCA1/2 mutation carriers. Recent studies have demonstrated that BRCA1/2 mutations also increased the risk of developing colon cancer, pancreatic cancer, skin cancer, and male prostate cancer. BRCA1/2 mutation patients have common molecular pathological basis, which may be independent of pathologi-cal tissue diagnosis in the future. Furthermore, it can serve as an important basis for clinical drug therapy, including chemotherapy drugs represented by platinum, PARP inhibitors, PD-1 antibodies, ALDH2 inhibitors, and mTOR inhibitors.

The changes in intestinal flora are usually associated with different gastrointestinal diseases, and intestinal flora homeostasis can enhance immune tolerance and regulate intestinal immune balance.Previous studies have found that the increase of the relative abundance of Bacteroides fragilis (B.fragilis) in Bacteroides intestinalis can significantly enhance the expression of intestinal regulatory T cells (Treg) and anti-inflammatory cytokines, thus alleviating intestinal inflammation.However, the mechanism of B.fragilis regulating intestinal immunity is still unclear.In this study, an acute colitis model was constructed by giving 3% DSS in drinking water solution to SPF-grade C57BL/6 mice for 7 days, and exogenous supplementation B.fragilis was given to mice by gastric gavage to study its regulatory effect on intestinal immunity and its mechanism of action.The results showed that B.fragilis could improve the intestinal flora disorder in mice with colitis and increase the content of short-chain fatty acids (SCFAs), the main metabolite of the intestinal flora.By extracting mouse tissue lymphocytes, naive CD4+ T cells, and liposome-modified siRNA knockdown mouse Smad3, it was further discovered by flow cytometry that B.fragilis induced the expression of intestinal Treg cells and related cytokines through the TGF-β/Smad3 signaling pathway, which enhanced intestinal regulatory immunity and alleviated colitis.It was also found that B.fragilis activated TGF-β by increasing the expression of reactive oxygen species (ROS), thus inducing Treg cell differentiation and playing an immunomodulatory role.

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Objective:To analyze the effect of Croton leaf on ERK1/2 pathway in hippocampal of rats with cerebral ischemia-reperfusion.Methods:A total of 216 SD male rats were divided into sham operation group, model group, nimodipine group, low-dose, medium-dose and high-dose groups of croton leaf according to random nubmer table method, with 36 rats in each group. The MACO model of rats was prepared by the method of wire embolization. The high, medium and low dose groups were intragastrated with the water decoction 0.06 g/ml, 0.12 g/ml and 0.18 g/ml of Croton leaf; nimodipine group was intragastrated with nimodipine suspension 1.08 g/L; sham operation group and model group were intragastrated with equal volume of normal saline. Garcia JH score was used to conduct neurological function score, and HE staining was used to observe the morphology of hippocampal neurons after 7 days of continuous administration. Apoptosis of hippocampal CA3/DG region was detected by TUNEL assay. Western Blot was used to detect the expression of ERK1/2 and p-ERK1/2 proteins.Results:Compared with the model group at simultaneous point, the neurological function scores of low-dose, medium-dose and high-dose groups of Croton leaf increased ( P<0.01), the number of apoptotic cells decreased ( P<0.01), the expression of p-ERK1/2 / ERK1/2 [1 d: (0.22±0.03, 0.34±0.02, 0.46±0.01 vs. 0.19±0.02); 3 d: (0.38±0.02, 0.50±0.02, 0.68±0.02 vs. 0.27±0.02); 7 d: (0.29±0.03, 0.43±0.02, 0.59±0.02 vs. 0.21±0.03)] in hippocampus of the low-dose, medium-dose and high-dose groups of Croton leaf significantly increased ( P<0.01). Conclusion:Croton leaf could regulate the expression of ERK1/2 pathway protein upward, effectively improve the neural function and resist the apoptosis of hippocampal CA3/DG area of rats with cerebral ischemia-reperfusion injury.

Background: Currently available guidelines contain conflicting recommendations on the management of blood pressure (BP) in patients with diabetes mellitus (DM). Therefore, it is necessary to appraise the guidelines and summarize the agreements and differences among recommendations. Methods: Four databases and the websites of guideline organizations were searched for guidelines regarding BP targets and thresholds for pharmacologic therapy in DM patients, and the included guidelines were appraised with the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Results: In 6,498 records identified, 20 guidelines met our inclusion criteria with 64.0% AGREE II scores (interquartile range, 48.5% to 72.0%). The scores of the European and American guidelines were superior to those of the Asian guidelines (both adjusted P<0.001). Most of the guidelines advocated systolic BP targets <130 mm Hg (12 guidelines, 60%) and diastolic BP targets <80 mm Hg (14 guidelines, 70%) in DM patients. Approximately half of the guidelines supported systolic BP thresholds >140 mm Hg (10 guidelines, 50%) and diastolic BP thresholds >90 mm Hg (nine guidelines, 45%). The tiny minority of the guidelines provided the relevant recommendations regarding the lower limit of official BP targets and the ambulatory BP monitoring (ABPM)/home BP monitoring (HBPM) targets and thresholds in DM patients. Conclusion The lower official BP targets (<130/80 mm Hg) in patients with DM are advocated by most of the guidelines, but they contain conflicting recommendations on the official BP thresholds. Moreover, the gaps regarding the lower limit of official BP targets and the ABPM/HBPM targets and thresholds need to be considered by future study.

Objective: This study aimed to evaluate the consistency or stability of mental disorders diagnosed in the psychiatry ward setting, investigate factors associated with consistency, and observe the disease distribution over the decade. Methods: A total of 20,359 psychiatric inpatients were included in this retrospective study from June 2011 to December 2020. Diagnoses from the first admission to discharge were evaluated to determine the diagnostic consistency during hospitalization. Readmissions were selected as the subgroup, whose first and last discharge diagnoses were compared to analyze the relatively long-term diagnostic stability. Demographic and clinical characteristics were collected to identify predictors of diagnostic discrepancy. Results: From 2011–2020, the hospitalization rate decreased from 42.7% to 20.7% for schizophrenia and grew from 13.3% to 23.8% for depression. Diagnoses were retained by 92.6% of patients at their first discharge diagnosis, ranging from 100% for disorders of psychological development to 16.3% for unspecified mental disorders. About 33.9% of diagnostic conversions were to bipolar disorder in patients having inconsistent diagnoses. However, among rehospitalizations, the diagnostic stability notably dropped to 71.3%. For rehospitalizations, mood disorders and schizophrenia spectrum disorders were relatively stable diagnoses categories, with 72.6% to 76.7% of patients receiving the same diagnosis, although results of specified diagnoses within these categories ranged from 5.9% to 91.0%. Except for mood disorders and schizophrenia spectrum disorders, the diagnoses of all other categories were below 70%. Long lengths of hospitalization and old age were associated with short-term diagnosis alterations. Conclusion Longitudinal follow-up and integration of multiple aspects of information are essential for accurate diagnosis.